How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $13.80 Median $13.80 Typical High $13.80 | Facility | None | $13.80 | $13.80 | $13.80 |
Aetna Setting Professional Modifier None Typical Low $10.47 Median $13.80 Typical High $13.80 | Professional | None | $10.47 | $13.80 | $13.80 |
BCBS North Carolina Setting Facility Modifier None Typical Low $12.88 Median $15.49 Typical High $16.60 | Facility | None | $12.88 | $15.49 | $16.60 |
BCBS North Carolina Setting Professional Modifier None Typical Low $9.12 Median $12.02 Typical High $15.85 | Professional | None | $9.12 | $12.02 | $15.85 |
Cigna Setting Facility Modifier None Typical Low $10.00 Median $10.00 Typical High $10.00 | Facility | None | $10.00 | $10.00 | $10.00 |
Cigna Setting Professional Modifier None Typical Low $8.51 Median $10.00 Typical High $11.48 | Professional | None | $8.51 | $10.00 | $11.48 |
Medcost Setting Professional Modifier None Typical Low $7.76 Median $8.32 Typical High $12.02 | Professional | None | $7.76 | $8.32 | $12.02 |
Medcost Setting Facility Modifier None Typical Low $4.57 Median $8.51 Typical High $15.14 | Facility | None | $4.57 | $8.51 | $15.14 |
Medcost Setting Professional Modifier None Typical Low $10.00 Median $11.75 Typical High $22.39 | Professional | None | $10.00 | $11.75 | $22.39 |
United Setting Professional Modifier None Typical Low $5.37 Median $7.41 Typical High $10.00 | Professional | None | $5.37 | $7.41 | $10.00 |
5 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.58 Median $2.04 Typical High $2.04 | Professional | 55 · Aftercare only | $1.58 | $2.04 | $2.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.07 Median $1.38 Typical High $1.38 | Professional | 56 · Pre-op care only | $1.07 | $1.38 | $1.38 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $5.01 Median $5.89 Typical High $17.78 | Professional | 51 · Multiple procedures | $5.01 | $5.89 | $17.78 |
Medcost Setting Professional Modifier SH · Second concurrent infusion Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | SH · Second concurrent infusion | $5.01 | $5.01 | $5.01 |
Medcost Setting Professional Modifier SJ · Third+ concurrent infusion Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | SJ · Third+ concurrent infusion | $5.01 | $5.01 | $5.01 |
Where North Carolina sits
The same service costs 2.3 times more in Montana than in Connecticut. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
North Carolina· 18th of 51
$12.02
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.